Women In Entertainment (WIE) Mentorship Mentee Application

Contact Information

Please note that all information received is confidential and becomes the property of Big Brothers Big Sisters of Greater Los Angeles. Big Brothers Big Sisters does not discriminate on the basis of race, ethnicity, sexual orientation, religion, or physical ability. Parent/Guardian approval will be required to submit application.

Referral Source

Please specify/name

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Gender

How do you identify?

Cell Phone

Home Phone

Work Phone

Parent/Guardian Preferred Phone

Parent/Guardian Best Time to Call

Parent/Guardian Personal Email

Parent/Guardian Contact Preference

Parent/Guardian Street Address

City

State

Zip Code

Parent/Guardian Employment Information (optional)

Parent/Guardian Employment Status

Parent/Guardian Employer

Employer Address Line 1

Employer Address Line 2

Employer City

Employer State

Employer Zip Code

Custody Information

Do you have legal custody of this student child?

YesNo

Does anyone share custody of this student child?

YesNo

How often does the student child see his/her other custodial parent/guardian?

WeeklyMonthlyOther

Other

Does the student child's other custodial parent/guardian know you are applying for a Big Brother/Sister?

YesNo

Family Doctor Information

Family Doctor Name

Family Doctor Phone

Family Doctor Address

Student Allergies

Type N/A if none

Emergency Contact Information

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone

Emergency Contact Relationship to Student

Essay Questions

Instructions for Essays:
Use Word Document to answer the 5 questions below individually or as one essay. Feel free to express yourself openly. There's no specific word count, but please provide detailed answers. Use your unique voice and writing style. Let's get to know you better!

Tell us your story. What should we know about your background, your values, and what makes you unique?
What is one major challenge you've faced - personally, academically, or at home? How did you grow and what did you learn from it?
What are your future goals - in school and in your career? What kind of college or career path are you hoping to pursue, and why?
Are there any personal responsibilities, time commitments, or challenges that might make it difficult to fully participate in the program? If so, how can we support you?
How would having a mentor impact your life? How would you feel about having a high-level executive as your role model? What would your ideal mentor be like?

Upload Essay Here

High School Transcript

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Photo of Yourself

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American Indian or Alaska Native	Asian - Chinese
Asian - Filipino	Asian - Indian
Asian - Japanese	Asian - Korean
Asian - Other	Asian - Vietnamese
Black or African American	Hispanic - Cuban
Hispanic - Mexican,Mexican American,Chicano	Hispanic - Other Latinx or Spanish origin
Hispanic - Puerto Rican	Middle Eastern or North African
Pacific Islander - Chamorro	Pacific Islander - Native Hawaiian
Pacific Islander - Other	Pacific Islander - Samoan
White or Caucasian	Other
Prefer not to say

English	Spanish
African Languages (Swahili, Bantu)	American Sign Language
Arabic	Asian: Other
Chinese	Creole
Dutch	Eastern European (Czech, Slovak)
French	German
Greek	Hebrew
Hmong	Indian (Hindi, Punjabi)
Italian	Japanese
Keres (West)	Korean
Nordic	Persian
Portuguese	Russian
Turkish	Lao